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Pathological complete response as a surrogate for relapse-free survival in patients with triple negative breast cancer after neoadjuvant chemotherapy

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ABSTRACT

We retrospective analyzed triple negative breast cancer (TNBC) patients who received either taxane-based or anthracycline-based neoadjuvant chemotherapy, evaluated whether pathological complete response (pCR) is a surrogate endpoint for relapse free survival (RFS) in TNBC and explored which subgroup of patients benefits more from superior treatment regimen. 186 patients received taxane-based (Group A) or anthracycline-based (Group B) neoadjuvant chemotherapy, median follow-up was 48.1 months. 42 patients received total pCR (ypT0/is ypN0), 34 in Group A and 8 in Group B, p < 0.001. Patients who achieved pCR had an increased RFS when compared with non-pCR patients, p = 0.043. Patients in Group A had a better RFS, p = 0.025, after adjusting for tumor size and clinical lymph node status before neoadjuvant therapy. Only patients sensitive to neoadjuvant chemotherapy exhibited RFS benefit from taxane-based treatment, and those who were treatment insensitive had similar RFS between both groups. Our analysis showed Taxane-based regimen had higher pCR rate and could predict improved RFS in TNBC, and the prognostic value was greater in treatment sensitive patients. This retrospective analysis supports the use of pCR as a surrogate endpoint for RFS in TNBC.

No MeSH data available.


Study designTaxane-based chemotherapy includes PC (paclitaxel and carboplatin) and DO (docetaxel and oxaliplatin). Anthracycline-based neoadjuvant chemotherapy includes CEF (cyclophosphamide, epirubicin, 5- fluorouracil) and NE (vinorelbine and epirubicin).
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Figure 1: Study designTaxane-based chemotherapy includes PC (paclitaxel and carboplatin) and DO (docetaxel and oxaliplatin). Anthracycline-based neoadjuvant chemotherapy includes CEF (cyclophosphamide, epirubicin, 5- fluorouracil) and NE (vinorelbine and epirubicin).

Mentions: All the patients received neoadjuvant chemotherapy in our institution from January 2000 to December 2012, with core needle biopsy (CNB)-diagnosed invasive breast cancer and a immunohistochemical (IHC) report of the CNB tissue-confirmed TN phenotype, defined as ER < 1% positive, PR < 1% positive, HER2 0 or 1-2+ with FISH negativity. Patients received 3-4 cycles of anthracycline-based neoadjuvant chemotherapy, such as CEF (cyclophosphamide, epirubicin, 5- fluorouracil) or NE (vinorelbine and epirubicin), or taxane-based chemotherapy, such as PC (paclitaxel and carboplatin) or DO (docetaxel and oxaliplatin). Patients who received both anthracycline- and taxane-based neoadjuvant regimens were excluded. Patients with metastatic disease before neoadjuvant chemotherapy were excluded. After neoadjuvant therapy, patients underwent surgical treatment in our center and detailed pathology reports were provided after surgery. Patients with breast-conserving therapy were excluded. All patients received mastectomy and axillary dissection. Patients received only anthracycline-based adjuvant chemotherapy (no taxanes). Patients who were ER and/or PR positive in post-operation pathology reports were administered endocrine therapy. Radiation therapy was conducted according to the features of the primary tumor (Figure 1).


Pathological complete response as a surrogate for relapse-free survival in patients with triple negative breast cancer after neoadjuvant chemotherapy
Study designTaxane-based chemotherapy includes PC (paclitaxel and carboplatin) and DO (docetaxel and oxaliplatin). Anthracycline-based neoadjuvant chemotherapy includes CEF (cyclophosphamide, epirubicin, 5- fluorouracil) and NE (vinorelbine and epirubicin).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5392337&req=5

Figure 1: Study designTaxane-based chemotherapy includes PC (paclitaxel and carboplatin) and DO (docetaxel and oxaliplatin). Anthracycline-based neoadjuvant chemotherapy includes CEF (cyclophosphamide, epirubicin, 5- fluorouracil) and NE (vinorelbine and epirubicin).
Mentions: All the patients received neoadjuvant chemotherapy in our institution from January 2000 to December 2012, with core needle biopsy (CNB)-diagnosed invasive breast cancer and a immunohistochemical (IHC) report of the CNB tissue-confirmed TN phenotype, defined as ER < 1% positive, PR < 1% positive, HER2 0 or 1-2+ with FISH negativity. Patients received 3-4 cycles of anthracycline-based neoadjuvant chemotherapy, such as CEF (cyclophosphamide, epirubicin, 5- fluorouracil) or NE (vinorelbine and epirubicin), or taxane-based chemotherapy, such as PC (paclitaxel and carboplatin) or DO (docetaxel and oxaliplatin). Patients who received both anthracycline- and taxane-based neoadjuvant regimens were excluded. Patients with metastatic disease before neoadjuvant chemotherapy were excluded. After neoadjuvant therapy, patients underwent surgical treatment in our center and detailed pathology reports were provided after surgery. Patients with breast-conserving therapy were excluded. All patients received mastectomy and axillary dissection. Patients received only anthracycline-based adjuvant chemotherapy (no taxanes). Patients who were ER and/or PR positive in post-operation pathology reports were administered endocrine therapy. Radiation therapy was conducted according to the features of the primary tumor (Figure 1).

View Article: PubMed Central - PubMed

ABSTRACT

We retrospective analyzed triple negative breast cancer (TNBC) patients who received either taxane-based or anthracycline-based neoadjuvant chemotherapy, evaluated whether pathological complete response (pCR) is a surrogate endpoint for relapse free survival (RFS) in TNBC and explored which subgroup of patients benefits more from superior treatment regimen. 186 patients received taxane-based (Group A) or anthracycline-based (Group B) neoadjuvant chemotherapy, median follow-up was 48.1 months. 42 patients received total pCR (ypT0/is ypN0), 34 in Group A and 8 in Group B, p &lt; 0.001. Patients who achieved pCR had an increased RFS when compared with non-pCR patients, p = 0.043. Patients in Group A had a better RFS, p = 0.025, after adjusting for tumor size and clinical lymph node status before neoadjuvant therapy. Only patients sensitive to neoadjuvant chemotherapy exhibited RFS benefit from taxane-based treatment, and those who were treatment insensitive had similar RFS between both groups. Our analysis showed Taxane-based regimen had higher pCR rate and could predict improved RFS in TNBC, and the prognostic value was greater in treatment sensitive patients. This retrospective analysis supports the use of pCR as a surrogate endpoint for RFS in TNBC.

No MeSH data available.